Miscarriage, premature delivery, bacterial infections: Conceiving while using an IUD has dangerous health outcomes for mother and infant

Women who happen to conceive while currently on an intrauterine contraceptive device (IUD) are more prone to pregnancy and delivery issues such as bacterial infections, preterm delivery, low weight term babies, or a miscarriage, a study conducted by researchers at Ben-Gurion University of the Negev and the Soroka University Medical Center, both in Beersheba, Israel, showed.

The study’s findings were presented at the Society of Maternal-Fetal Medicine’s 38th Annual Pregnancy Meeting in Dallas, Texas on Jan. 29 to Feb. 3, 2018.

“We believe this is the first report tracking children born to mothers using an IUD over a long timeframe. Working with a large sample over 23 years allowed us to investigate obstetric parameters that hadn’t been examined previously in large groups,” said Dr. Gali Pariente, a faculty member of the BGU Division of Obstetrics and Gynecology, BGU Faculty of Health Sciences, and a clinical instructor at Soroka.

IUDs are the most common forms of reversible contraceptives (birth control devices that provide effective contraception for an extended period of time without requiring user action, which is required of latex or rubber condoms) worldwide.

According to a 2015 United Nations report on world contraceptive use, IUDs are as effective as sterilization but are not as permanent, and have been the preferred birth control method for 23 percent of female contraceptive users. (Related: Copper toxicity and birth control.)

That said, around one in 200 women with an IUD conceive each year. The risk of IUD failure is at its peak within the first year of insertion.

The uterus “thinks” of the IUD as a foreign body, thereby emitting an inflammatory action that dispels any kind of sperm implantation. Adding copper or progesterone to the IUD only inflames this response even more, and installs more shields to prevent sperm binding with an egg.

This latest study had researchers comparing the outcomes of 221,800 deliveries between the years 1991 and 2014. This time period showcased almost one percent (203) of the women who delivered babies having an IUD which was taken out early in the pregnancy and six percent (149) keeping their IUD throughout the gestation period, or the process between conception and birth.

Women who got pregnant while having an IUD were more prone to having one or more adverse outcomes such as:

Preterm delivery – 14.3 percent of pregnant women who took away their IUD and 14.1 percent of them who kept on their IUD had preterm deliveries versus 6.8 percent without an IUD.

Bacterial infection – Almost five percent who removed their IUD and 2.7 percent who kept their IUD developed a bacterial infection versus 0.6 percent without an IUD.

Low birth weight – 11.3 percent who took out their IUD and 12.1 percent who kept their IUD delivered babies who weighed less than five pounds versus 6.6 percent without an IUD.

Perinatal mortality – Two percent who took out their IUD and 1.3 percent who kept their IUD miscarried versus 0.5 percent without an IUD.

“Because of the elevated risks of severe, adverse short-term perinatal complications, we recommend careful monitoring of any women who conceive while using an IUD,” said Dr. Pariente.

What to do when a woman suspects a pregnancy while using IUD

A woman needs to follow these steps if she suspects that she is pregnant while using an IUD. Take note that it is normal for a woman using an IUD to suspect that she is pregnant because doing so can subject a woman to have irregular bleeding during the first few months after IUD insertion.

First, she needs to take a pregnancy test. After confirming that she is pregnant, she should see her doctor immediately to alleviate concerns that her pregnancy is ectopic. After making sure that that isn’t the case, she needs to schedule an IUD removal with her doctor, because the risk of miscarriage increases when the IUD is not taken out during the pregnancy.